ASSOCIATES IN DERMATOLOGY OF TRAVERSE CITY PC (NPI# 1861430779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861430779 |
| Entity Type | Organization |
| Organization Name | ASSOCIATES IN DERMATOLOGY OF TRAVERSE CITY PC |
| Other Organization Name | ASSOCIATES IN DERMATOLOGY OF TRAVERSE CITY |
| Practice Address |
3643 W Front St Traverse City MI 49684-7759 |
| Mailing Address |
3643 W Front St Traverse City MI 49684-7760 |
| Practice Telephone | 2319350625 |
| Practice Fax Number | 2319350626 |
| Mailing Telephone | 2319350625 |
| Mailing Fax Number | 2319350626 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2007-10-25 |
| Authorized Official Name | DR. JOAN MICHELLE GRINER (PRESIDENT) |
| Authorized Official Telephone | 2319350625 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
JG058054 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RAILROAD MEDICARE | DF3512 | 01 |
| Other Name | Type Code |
|---|---|
| ASSOCIATES IN DERMATOLOGY OF TRAVERSE CITY | Doing Business As Name - Organization |
| Street Address |
3643 W FRONT ST |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-7759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487646923 | John J Gorman | Internal Medicine | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2005-08-19 |
| 1588876254 | Mary Bonnie Smith | Nurse Practitioner | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2007-05-04 |
| 1730208349 | Amy Lynn Ream | Specialist/Technologist | 3643 W Front St, Suite B, Traverse City, MI 49684-7759 | 2007-03-28 |
| 1831224765 | Curt Jeffrey Schubert | Internal Medicine | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2007-02-22 |
| 1528168895 | Northern Michigan Medicine and Pediatrics, Pllc | Pediatrics | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2006-09-25 |
| 1770565384 | Jeffrey John Kelly | Dermatology | 3643 W Front St, Suite A, Traverse City, MI 49684-7759 | 2005-11-18 |
| 1871585174 | Margaret J Meeker | Pediatrics | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2005-08-22 |
| 1295727774 | Walter K Meeker | Internal Medicine | 3643 W Front St, Suite C, Traverse City, MI 49684 | 2005-08-19 |
| 1104818681 | Robert E Kuhn | Internal Medicine | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2005-08-19 |
| 1922090406 | Sherry L Small | Pediatrics | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2005-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114489945 | Novice Aesthetics and Dermatology Pllc | Dermatology | 4120 W Maple Rd Ste 206, Bloomfield Hills, MI 48301-3068 | 2019-04-01 |
| 1962585596 | Wei Su | Dermatology | 43900 Garfield Rd Ste 100, Clinton Township, MI 48038-1137 | 2006-10-24 |
| 1629090691 | Janine Mangini | Dermatology | 16520 19 Mile Rd, Clinton Twp, MI 48038-1106 | 2006-07-25 |
| 1619909611 | Nicole M. Bossenbroek | Dermatology | 6225 Prairie St, Norton Shores, MI 49444-7831 | 2006-07-07 |
| 1104874411 | S L Husain Hamzavi | Dermatology | 43151 Dalcoma Dr, Suite 1, Clinton Twp, MI 48038-6306 | 2006-05-05 |
| 1528052834 | John Michael Pelachyk | Dermatology | 1602 Military St, Port Huron, MI 48060-5933 | 2005-09-01 |
| 1528599750 | Singer Dermatology | Dermatology | 29355 Northwestern Hwy, 302, Southfield, MI 48034-1053 | 2017-03-21 |
| 1538538178 | Specialized Pathology Partners PC | Dermatology | 4798 Wenmar Dr, Saginaw, MI 48604-2843 | 2015-09-24 |
| 1255724100 | West Michigan Pathology Specialists, PC | Dermatology | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2015-03-16 |
| 1760812523 | Scott Conley Bresler | Dermatology | 1500 E Medical Center Dr, 2nd Floor University Hospital Recp Pathology, Ann Arbor, MI 48109-5054 | 2013-11-14 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
Please comment or provide details below to improve the information on ASSOCIATES IN DERMATOLOGY OF TRAVERSE CITY PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.